Chikungunya Virus: Reporting and Surveillance
- Electronically through the Wisconsin Electronic Disease Surveillance System (WEDSS).
- By calling the Bureau of Communicable Diseases at 608-267-9003.
Reporting should be completed within 72 hours upon recognition of a case. For more information, please visit the DHS Disease Reporting page.
DHS Surveillance Resources
- Arboviral Infection EpiNet, P-01930 (PDF): An arboviral infection case reporting and investigation protocol for health professionals.
- Arbovirus Management Protocol, P-00894 (PDF): Information for arboviral disease management, including surveillance, testing, reporting, and follow-up, in humans and animals.
Chikungunya Virus Information for Health Care Providers: Information from the Centers for Disease Control and Prevention (CDC) on clinical evaluation and disease, diagnostic testing, and resources for healthcare providers.
Laboratory diagnosis of chikungunya virus most often involves the detection of viral RNA or antibodies against chikungunya virus. Molecular methods, commonly reverse-transcription polymerase chain reaction (RT-PCR), should ideally be performed on acute specimens collected in the first eight days of symptoms. Serologic testing can be performed on specimens collected between eight days and 12 weeks from the onset of symptoms. Often, collection of both acute and convalescent specimens may be necessary to make a diagnosis of chikungunya infection. For further information on laboratory diagnosis of chikungunya infection, please visit CDC Chikungunya Laboratory Guidance.
Chikungunya virus testing is not widely available at commercial laboratories, but can be requested through the Wisconsin State Laboratory of Hygiene (WSLH) using an arbovirus PCR panel (includes tests for chikungunya, dengue, and Zika viruses) or chikungunya IgM antibody capture enzyme-linked immunosorbent assay (MAC-ELISA). Chikungunya IgM antibody testing is performed at the CDC and any specimens with positive IgM results will be tested for the presence of neutralizing antibodies using plaque reduction neutralization test (PRNT).
The arbovirus PCR panel is only available at the WSLH fee-exempt and requires patients to meet the Division of Public Health (DPH) clinical and travel exposure criteria. Please contact a vectorborne disease epidemiologist at 608-267-9003 to obtain authorization prior to specimen submission.Chikungunya IgM testing is available at the WSLH fee-for-service. It is not required for patients’ symptoms to meet DPH clinical and travel exposure criteria to submit serum specimens to WSLH for chikungunya MAC-ELISA.
DPH monitors for chikungunya virus as part of our enhanced arbovirus surveillance. Serologic and molecular testing for chikungunya virus as part of a DPH investigation may be fee-exempt. Please contact a vectorborne disease epidemiologist at 608-267-9003 for fee-exempt approval.
Fee-exempt arboviral testing will be offered to clinicians whose patients meet ONE of the following criteria:
- Request for confirmatory testing of chikungunya positive IgM and IgG commercial test results (performed at laboratories other than the WSLH).
- The patient has a least two of the following signs and symptoms: fever, arthralgia, headache, rash.
- The patient has a history of travel to chikungunya affected areas within two weeks of illness onset.
- The local health department may request fee-exempt testing be performed if the case-patient lacks insurance coverage or the ability to pay.
Instructions for collection and shipping of clinical specimens to the WSLH:
- Submit 3-7 mL of serum in sterile screw-capped vials on cold packs using a WSLH kit #22 or equivalent with five days of collection. Specimens should be triple packaged as a Category B Biological Substance (include UN3373 label).
- Fee-exempt testing submissions must include a WSLH Enhanced Wisconsin Arbovirus Surveillance form provided by a DPH vectorborne disease epidemiologist.
- Fee-for-service testing submissions must include a WSLH CDD Requisition Form B. Please contact the WSLH Clinical Orders at 800-862-1088 or 608-224-4275 to obtain blank copies of WSLH CDD Requisition Form B and to order specimen shipping kits.
- It is essential that the lab requisition form be as complete as possible, including patient name, city, date of birth, specimen type, submitting agency, onset date, signs and symptoms, collection date, and recent travel history. Note: Testing for chikungunya virus may be delayed on specimens missing the above data until information is available.
- Ships specimens with appropriate completed form to:
Wisconsin State Laboratory of Hygiene
2601 Agriculture Drive,
PO Box 7904
Madison, WI 53718
Customer Service: 800-862-1013
Diagnosis of chikungunya should be considered if a patient has acute onset of fever and arthralgia, and has recently traveled to an area with known chikungunya virus transmission. Diagnosis of chikungunya can be complicated by the fact that dengue and Zika viruses are transmitted by the same mosquitoes, have overlapping geographical ranges, and have similar clinical presentations.
Compared to dengue and Zika virus infections, chikungunya virus infection is more likely to cause high fever, severe arthralgia, arthritis, and lymphocytopenia. Additionally, chikungunya IgM antibodies can cross-react with related viruses, requiring confirmatory laboratory testing and/or convalescent specimen collection. A patient’s clinical signs and symptoms and risk activities can help to inform a preliminary diagnosis prior to laboratory confirmation. For additional information on clinical diagnosis of chikungunya, visit CDC Chikungunya Clinical Guidance.
There is currently no treatment or vaccine for chikungunya. Over-the-counter pain relievers may be given to relieve acute pain and fever. In severe cases, patients may need to be hospitalized to receive supportive treatment.
Questions about illnesses spread by mosquitoes? Contact us!
Phone: 608-267-9003 | Fax: 608-261-4976